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Other malabsorption causes include: Atrophic gastritis and reduced gastric acid production (common in older adults) Gastrointestinal surgery, particularly gastrectomy, ileal resection, or bariatric surgery (especially gastric bypass) Inflammatory bowel disease affecting the terminal ileum (Crohn's disease) Coeliac disease and other small bowel disorders Chronic pancreatitis affecting enzyme secretion Helicobacter pylori infection (may contribute to reduced absorption) Medication-related deficiency is increasingly recognised

10.1093/ajcn/nqy072 [DOI] [PubMed] 33.Sezer RG, Akolu HA, Bozaykut A, zdemir GN (2018) Comparison of the efficacy of parenteral and oral treatment for nutritional vitamin B12 deficiency in children

72 Vitamin B 12 deficiency at the brain level is associated with affective disorders, behavior changes, psychosis, cognitive impairment or decline, and dementia (including Alzheimers disease and vascular dementia protection)